Prominent or Deformed Ears

While ear deformities are not as extreme as microtia, parents of children with deformed ears know too well that the diagnoses are commonly made by a teasing world. If you have concerns about your child, or if your child feels unhappy with the appearance of his or her ears, at Wellspring we can help. Our surgeons offer a conservative, aesthetically-thoughtful, professional opinion–and expert care–if treatment is decided as an appropriate course of action. Ear correction continues to be one of our top services, and our surgeons enjoy working with children and their families in this way.

What Are The Types of Ear Deformities?

Image source: Thinkstock

Image source: Thinkstock

Congenital ear deformities are those that are present at birth. An ear’s shape is defined by folds and valleys in the cartilage which are formed embryologically by the fusion of two separate structures, called “pharyngeal arches.”

If any of these folds or valleys form incompletely or incorrectly, then the ear takes on an abnormal shape. The most common in order of decreasing frequency are

  • prominent or “cup ear”
  • lidding or “lop ear”
  • mixed deformity
  • Stahl’s (Spock) ear
  • helical rim deformities
  • conchal crus
  • cryptotia.

A prominent ear deformity, referred to as “lop-ear” or “cup ears,” is a deformity involving a projection of the ears from the head, more than the normal distance from the skull. This can occur from an increase in the angle of the ear cartilage, an excess of conchal cartilage, or an absence of the antihelical fold. Combinations of these causes frequently occur.

The constricted ear deformity is characterized by a partial absence of skin and cartilage which involves the helical rim, scapha, and/or concha. The tilting-over of the helical rim is  a deficiency in the anterior skin between the scapha and rim.  Most often if the cartilage is involved this will require ear reconstruction with a rib graft.

What Are My Options for Treatment?

The medical community classifies treatment for ear deformities into two general categories based on timeframe of diagnosis:

  1. deformities diagnosed within the first weeks of life
  2. deformities identified after infancy

If parents and pediatricians identify the deformity within the first weeks of life,  then a non-surgical treatment option is available called ear molding. Ear molding takes advantage of a narrow window in which the ear cartilage is malleable and has not yet gained “memory.” (Cartilage “memory” is the reason a child or adult can fold their ear and expect the ears to spring back to the original shape when released).

Surgical correction, or otoplasty, addresses congenital ear deformities identified in childhood. Ear shaping surgery is usually delayed until kindergarten age. This allows correction prior to starting 1st grade, and allows the ears to nearly reach adult size (ears reach 85% of their adult size by age 6).